Individual
CHRISTINE M SUSURAS
Active
Individual
CHRISTINE M SUSURAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2743
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86080015085259C464
TRIWEST
AZ
05
—
939796
—
AZ
01
—
P00625190
RAILROAD MEDICARE
AZ
Enumeration date
12/07/2005
Last updated
10/29/2008
Update your record
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